March 2020 PULSE

MARCH 2020

IN THIS ISSUE

MISSION CRITICAL

Clinician’s Corner by Miguel Santiago Food for Thought: Strength & Conditioning within Physical Therapy Education

PTSMC Partners & Directors and Admin leadership just completed our 2019 “Year End Leadership Meeting.” The focus of this annual meeting is to take stock of the previous year and to look ahead. Did we accomplish what we set out to do? Are we proud of our people and ourselves? Where did we miss the mark? How do we continue to improve? Are we preparing to be better tomorrow than we are today?

2020 Courses Upcoming Doc Talks

First, the numbers.

A “30,000-foot view” tells the big picture story. PTSMC provided care to with PTSMC in the past. Our patients continually choose to return to a 21,311 new patients in 2019, and overall visits exceeded 251,000. trusted clinician and organization when they need physical therapy Compared to 2018, we grew our new patients by 23% and total visits because of the relationships they’ve built inside and outside the clinic. were up by over 50,000! This represents a year-over-year growth of 26%. Additionally, PTSMC added 4 locations and 21 new staff, full and “Self-referred” new patients, those that came directly to us, part time. Objective business measures reveal an exceptionally healthy represented 20% of our total new evaluations in 2019. That number and growing organization. The question is, how did they happen, and far exceeds the referrals from our best physician relationships, indicating that our efforts to educate patients on how they can how can we continue these impressive trends? access us directly has been a huge success. We should continue to build these relationships and educate our patients on the many Unmatched Experiences. benefits of physical therapy and direct access.

Each and every PTSMC employee contributes to our customer experience. The commitment to assure our patients an unmatched experience every time they enter a PTSMC clinic makes our organiza- In addition, online testimonials and patients referring family members, friends and others are exploding. Word-of-mouth referrals tion different from most. Customer-centricity doesn’t happen and those who find us through positive reviews remain the top ways everywhere, and it doesn’t happen by accident. new patients come to us, and this is all thanks to the excellent care our Going above and beyond to improve the quality of people’s lives is an clinicians provide and the positive environments our clinics have created. In short, the majority of these new patients are the result of individual, team and organizational commitment. Caring from the heart, with purpose and intention, is the secret sauce for growth and the strong relationships you build in the clinic. opportunity.

Back to the numbers.

50,000 more visits, 4 new locations, just over 300 full-time and Clinical Excellence. part-time employees. These are all impressive numbers, but most Orthopedic Residency, Mentorship, Internal and External continuing education, the DOCS program, Inservice presentations; we have made importantly, how did we perform where it matters most? What did our customers think? a huge commitment of the time and financial resources required to attract and develop great clinicians.

Our NPS score, the measure of customer satisfaction and loyalty, went The clinicians we strive to bring to our team are those committed to from 90 in 2018 to 92 in 2019! That is just incredible – “World Class” by being on the leading edge of clinical knowledge and delivery. all measures! I believe we should all look ahead with the confidence At PTSMC, we want the best and strive to help them get better! that 2020 is on solid ground to be another outstanding year of growth and opportunity for us all.

Lifelong Relationships.

The communities we serve appreciate who we are and what we do.

The road races, coat drives, food drives, educational presentations, and I also encourage each of you to reflect on 2019 with great pride. patient appreciation days are just a few of the ways we establish deep Improving the quality of people’s lives is a pretty awesome thing to do for a living. I hope you are as proud as I am of what we are building roots and lasting bonds with the people and organizations in our together. communities.

In 2019, 40% of our “new patients” were people who had spent time

Alan

Wethersfield Grand Opening Thank you to everyone who attended the Wethersfield Grand Opening & Ribbon Cutting on February 25th. Pictured on the top from left to right: Present & Ownder Alan Balavender, Partner & Director Kasey Adinolfi, and Wethersfield Mayor Michael Rell.

Pictured on the bottom from left to right are the Wethersfield staff: Kasey Adinolfi, PSC Rachel Bellone, and PT Aide Leah Szot.

The Extra Mile by Kristen Forster Tips for a Positive Phone Experience Techy Tips by Dave Lawrence 3 Tips to Keep Your Devices Secure HR Buzz HR Road Trips Vacation Reminders D4Ds and Goals & Objectives Wellness Program Lifebeat - 4 Day Detox Soup Recipe Spring #GetMoving Dates Flu-Proof Your Home

20 Years in Review Out of our 323 current employees,

9 10

were born in 2000

were not born yet

143

were between the ages of 1 and 5

CLINICIAN’S CORNER FOOD FOR THOUGHT

Strength & Conditioning within Physical Therapy Education

By Miguel Santiago, PT, DPT, CSCS Physical Therapist at PTSMC West Hartford Sixteen years ago, during the prestigious 2004 Mary McMillan Lecture, Dr. Marilyn Moffat noted that, among robust technological and medical advances, physical therapists have a marked lack of exercise expertise despite the Guide to Physical Therapist Practice placing therapeutic exercise first in the hierarchy of interventions used by physical therapists. Several years later, Dr. Moffat spearheaded a 2013 task force appointed by the Board of Directors of the American Council of Academic Physical Therapy (ACAPT) to “review entry-level curricula and determine the current status of program curricula in advanced exercise physiology/science, exercise prescription and nutrition as it relates to exercise and physical activity, with the purpose of developing recommendations for education approaches to address the APTA position statement” at that time.

The task force recommended that programs integrate the following categories into curricula: 1. Exercise physiology / nutrition 2. Exercise testing 3. Exercise principles and prescription 4. Fitness theory and practice 5. Health promotion, wellness, and prevention In the first part of the last century, when physical therapy education was primarily hospital-based, there was a large emphasis on physical education. In the 1970s, as PT education progressed to a more academic setting requiring a Bachelor’s degree, the curricula dedicated to physical education and exercise science decreased and has continued to do so with the subsequent introduction of a Master’s and then a Doctoral degree requirement. To this day, however, physical therapists are purported to be experts in physical activity and exercise prescription, and the APTA has made attempts for the profession to become the leader in the promotion of health and wellness.

Although there has been increased effort to promote the importance of strength and conditioning within the profession as part of the continuum of health and wellness, strength and conditioning and rehabilitation are often seen as separate entities. Traditionally, physical therapy is viewed as the rehabilitation of an individual following an injury, while strength and conditioning focuses on the improvement of performance of the healthy individual. Given the high level of evidence supporting exercise as an effective physical therapy intervention, it seems important that exercise science and strength and conditioning principles have a major focus in all entry-level DPT programs and beyond.

While a strength and conditioning certification is not required to practice, I urge all clinicians to immerse themselves within the strength and conditioning community. In general, the foundational

knowledge behind strength training is what drives the physical therapy profession. Fundamentals such as overload principle, specificity, and general strength programming can help supplement therapeutic interventions and organize an appropriate POC. Some of the softer skills of strength and conditioning such as verbal/manual cueing, exercise variability, and session management can also help new graduates and experienced clinicians develop their own clinical “tool box.” With the lack of exercise prescription offered by many academic institutions, it is important that we as clinicians push the profession forward and educate ourselves in all areas of human movement to better serve our patients.

As clinicians at PTSMC, it is our mission to improve the quality of people’s lives through unmatched experiences, clinical excellence, and lifelong relationships. With the popularization of exercise through means such as Crossfit, Orange Theory, and many others, it is important to expand our clinical knowledge to be able to relate to all patients at a deeper level and provide those unmatched experiences described in our company’s mission statement. By immersing ourselves in areas of weakness, we not only improve our clinical excellence but we create better rapport with our patients and other like minded health professionals. These relationships then lead to improved physical outcomes within the clinic for our patients and help grow our reputation outside the clinic to make us one of the most trusted providers in the area.

At the end of the day, good strength and conditioning is good physical therapy and good physical therapy is good strength and conditioning!

Let’s, as individuals, as a company, and as a profession continue to educate ourselves and continue to strive for the very best to inspire our patients to move well, be strong, and enjoy life!

References: Moffat M. Thirty-Fifth Mary McMillan Lecture: Braving new worlds: to conquer, to endure.

Phys Ther. 2004;84:1056 –1086. https://www.acapt.org/docs/default-source/reports/ac-5-12_exercise_phys_tfreport_060413.pdf?sfvrsn=4 Moffat M. A History of Physical Therapist Education Around the World. Journal of Physical Therapy Education. 2012;26(1):13-23. doi:10.1097/00001416-201210000-00005.

Reiman MP, Lorenz DS. Integration of Strength and Conditioning Principles into a Rehabilitation Program. Int J Sports Phys Ther. 2011;6(3):241-253.

Hoover DL, Vanwye WR, Judge LW. Periodization and physical therapy: Bridging the gap between training and rehabilitation. Physical Therapy in Sport. 2016;18:1-20. doi:10.1016/j.ptsp.2015.08.003.

Bezner JR. Promoting health and wellness: implications for physical therapist practice. Phys Ther. 2015;95:1433–1444.

CLINICAL EXCELLENCE

Congratulations!

2020 Courses Email coned@ptsmc.com to attend

Email coned@ptsmc.com to register

Concussion: A Conceptual Framework for Evaluation & Management October 3-4, 2020 Instructors: Anne Mucha & Victoria Kochick PTSMC Windsor PTSMC Sponsored Course

Lower Extremity March 21, 2020, 8am - 12pm Intstructors: Joe Allen & Melissa Boutagy PTSMC Orange Internal Course Graston M1 May 2, 2020 Intstructor: Jackie Shakar PTSMC West Hartford PTSMC Sponsored Course PTSMC Clinician $550, Student $400

2020 Internal Courses - Dates TBD Return to Sport Cervical Spine

Upcoming Doc Talks Dr. Glenn Russo of COS

“Sagittal Imbalance and Spinopelvic Alignment” Tuesday, March 3rd at 6:30 pm PTSMC Orange RSVP to Danielle at Danielle.Butsch@ptsmc.com

Rebecca Petrosino (left), Fairfield Partner & Director, Mike Gans, Guilford Physical Therapist and Director of Clinical Excellence & Residency Program, and Joanna Fisher, Waterbury Physical Therapist,were recognized at the APTA Combined Section Meeting in Denver, CO. Rebecca and Mike were recognized for their 10 year recertifications as Board Certified Orthopaedic Specialists. Joanna was recognized for becoming a Board Certified Orthopaedic Specialist.

Tox Talks

Liz Saunders, Jeff Daley, & Dr. Alex Dukas of Orthopaedic Sports Specialists

“Neuroplastic Considerations in Orthopedic Rehabilitation” Wednesday, March 25th at 6 pm Tox Brewing - next to PTSMC New London More info to come. RSVP to Danielle at Danielle.Butsch@ptsmc.com

Thanks to everyone who attended our last two doc talks! First, Dr. Michael Kuhn of Orthopedic Associates of Middletown presented on cartilage repair at the Middletown clinic (top) on February 20th.

Dr. Robert Arciero of UConn Health presented on the current status of ACL revision at the Avon clinic on February 21st.

STUDENT PROGRAM UPDATE This month we’re pleased to welcome three students who will complete clinical affiliations with PTSMC over the next several months!

Yong Kim (AIC) will be presenting on Blood Flow Restriction Therapy on March 13th at 12:30 pm in Avon.

Michael Constantini (Quinnipiac) will be presenting “Overview of Recent Trends in Surgical Intervention of Glenohumeral Complex” on March 20th at 12:15 pm in Watertown.

Regina Cortez (Quinnipiac) will be presenting on the Examination and Treatment of Scoliosis on March 24th at 12:30 pm in Branford.

Emma Hart (UConn) will be presenting the Dynamic Leap and Balance Test on March 27th at 12:30 pm in Groton.

RSVP to the clinic if you would like to attend.

HUMAN RESOURCES CURRENT JOB OPPORTUNITIES Road Trips

HR is hitting the road again! Be on the lookout for an EMAIL with the day Karen Havlicek or Sandra Boccialetti will be in your clinic.

March Dates Tuesday, March 3rd Thursday, March 5th Tuesday, March 17th Thursday, March 19th Monday, March 30th

New London New Haven Southington New Milford Orange

Sandra Karen Karen Sandra Sandra

This is a great opportunity for you ask questions or chat. We are here to help and support YOU in any way we can.

Examples of what you may want to discuss are: • Paychex Flex system • Benefits • Policies • 401(k) • D4Ds • Just talk about how everything is going in your position Our goal is to have an opportunity to touch base with all of you. If you’d like to schedule a specific timeslot, the email will contain a link you can use to sign up for a time that best fits your schedule. Clinicians block your WebPT schedule as needed. We look forward to seeing all of you and will bring some healthy treats for everyone to enjoy.

Vacation Reminder

Be sure to use your vacation time before your anniversary date!

Vacation time must be used within an employee’s anniversary year. Employees may use up to 40 hours of time prior to accrual at the director’s discretion.

D4Ds and Goals & Objectives

All employees should be nearing or have completed 2019 D4Ds and 2020 Personal Goals & Objectives.

Employees fillable D4Ds and Goals & Objectives will be uploaded into Human Resources in employee documents.

To view Login to Paychex Flex and click on Under Personal Information click on Employee Documents & Links

Patient Services Coordinator Danbury Guilford Wallingford Windsor

Physical Therapist New London New Milford Wallingford West Hartford Westbrook Windsor Float PT

Athletic Trainer Essex

Physical Therapy Aide New London Plainville Westbrook

Clinical Compliance Coordinator Admin *must be a PT, 16 hours/week

Check PTSMC.com for our most up to date postings and feel free to share!

Call Jenn or email at jenn.detlefsen@ptsmc.com if you are interested in a PT Aide position. Call Karen or email at karen.havlicek@ptsmc.com if you are interested in a position other than PT Aide.

MARCH BIRTHDAYS Lindsey Scianna Renee Gallant Alison Pearce Pat Kinsella Bailey McPherson Joanna Fisher Tom Kirsch Victoria Arlia Danielle Pilgrim Lauren Jameson Zack Currie Dave Lawrence Julianne Balavender Danielle Jaffer Nancy Chilson Dana Earle Devin Defonce Mikayla Raffone Shelby Howe Amanda Baldwin Jenna Bouffard Donna Baribault Heather Feiner Brooke Uliano Stephanie Brilla Ted Raczka Gabby Didiano Janelle Berry Linda Easterling Bill Chapin Gabrielle Alessi

1 3 4 4 7 7 8 8 10 12 12 13 13 15 16 17 17 17 18 21 21 22 24 26 26 26 27 27 29 30 31

Watertown New Haven Admin Guilford Wallingford Waterbury Avon Wallingford New Milford New Haven Guilford Admin Admin Southington Avon Southington Southbury New Haven Avon Westbrook Watertown Admin Admin New Haven Southington Branford Middletown Wallingford New London Branford Fairfield

MARCH ANNIVERSARIES Amber Manville Hannah Joyner Jacky Severence Zach Rodegher

Physical Therapist PT Aide PSA PT Aide

Southbury New London Middletown Newington

Linda Easterling

PSC

New London

Sandy Wickman Mason

VP of Operations

Admin

EMPLOYEE NEWS

NEW EMPLOYEES Welcome to PTSMC. We’re so happy to have you!

From Left to Right: Dhimitri Stojko, PT Aide Southbury Rachel Ricciuti, PT Aide New London Alyssia Mosley, PT Aide Orange

Back Row From Left to Right: Hannah Stamm, PT Aide Wallingford Kaylynn Harmann, PT Aide Southbury

Front Row From Left to Right: Emily Gomes, PT Aide Plainville April Alver, PT Aide West Hartford Maeve Balavender, Office Assistant Avon

StriveHub Fab 5 “Wonderful attentive service. I’ve had my share of Physical Therapy and this is not your usual assembly line PT. They pay attention and provide great supervision. A great group and a pleasure to work with them.” - Fairfield

Meaghan Battige, Assistant Director of Windsor, and her husband welcomed Thea James Brunelle on February 2, 2020.

She was 8 lbs, 5 oz and 21 inches long.

Anthony Ciaburri, Partner & Director of PTSMC Orange, was elected to the Orange Economic Development Council.

“PTSMC is a well-oiled machine! My program challenges me each week, the staff is competent and engaging, and Craig (Katko) explains the processes of manipulation as well as extra information on home care and daily activity provisions so I keep improving.” - Essex “Mary (Clark) is so knowledgeable, helpful and informative. She has helped me improve tremendously from different injuries. Also the front desk staff always help me find appointments that work for me! ” - New Haven “PTSMC is amazing! The staff is so kind and caring. The atmosphere is warm and welcoming. The staff cares about your health and about you as a person. I will always recommend this office for PT needs.” - Watertown ”I enjoyed having Michael (McGowan) as my therapist. He was extremely competent, professional, helpful and caring. He answered all my questions and addressed all my concerns. Oh yes, the staff was was friendly and also helpful.” - Windsor

The

Extra MILE

By Kristen Forster Director of Operations

Tips for a Positive Phone Call Experience You rang?

A patient’s first interaction with PTSMC is most likely over the phone. Here are some tips to make sure we give patients a positive phone experience: Answer the phone within 3 rings Speak clearly and take your time Listen and don’t interrupt Ask permission to place someone on hold and make sure to wait for their response QUIZ TIME! PTSMC’s Phone Greeting is...

WRONG: “Physical Therapy & Sports Medicine Centers. Melissa speaking. How can I help you?”

Congratulations!

Congratulations to Vicki Palmieri in Wallingford on her promotion to Patient Services Administrator! Vicki started at PTSMC in January 2015. She brought with her over 10 years in the Payer environment, first with United Healthcare and then with Anthem Blue Cross & Blue Shield. This knowledge has served her well in her role at PTSMC. In 2015, our Wallingford clinic was treating an average of 28 patients/day. In the past couple of years, under Michelle Kijewski’s leadership, there has been a steady and consistent growth. Wallingford has grown to four full time physical therapists, and they are on the hunt for a fifth; the clinicians are currently treating about 50 patients/day. Vicki has assisted in managing the front desk operations and the front desk staff and she will continue to do so in a more formal way.

Michelle commented, “We have managed our growth really well and Vicki has been a constant throughout; her knowledge of the payer landscape, her great humor and work ethic are greatly appreciated and are a relief to me and my staff.

We are all excited for her in the new role.”

Vicki is really excited for the challenge of additional responsibilities. She said, “I want our office to be the best, most organized office with a smooth workflow to ensure our patients have the best experience at PTSMC. I look forward to having more oversight on the processes within our office and working with Michelle to exceed our office goals. We have a great team who works well together, and I am confident as a team we strive to always be the BEST!”

RIGHT: “Physical Therapy & Sports Medicine Centers. This is Melissa. How may I help you?”

Being a resident of Wallingford has been an asset for Vicki, as she often knows many of the clinic’s clientele. It was through Michelle’s BNI connection with Vicki’s husband that she applied to PTSMC! In her free time Vicki loves to travel with her family. One of their favorite spots is Las Vegas. They plan to eventually make Vegas their permanent home. Vicki is also a Miss Fixit! She loves a home project, most recently repairing her dishwasher.

When not traveling, she can be found hanging out with family and her pugs, Lexi and Lola,

Techy By Dave Lawrence Information Systems Coordinator Tips 3 Tips to Keep Your Devices Secure Mobile devices: If you need to leave your device in the car, keep it in an undisclosed bag and preferably leave it in your trunk where it’s out of sight from a petty thief.

Desktop devices: Make sure that devices are in a secure area where no one else has access to the device. If you’re not using it, logoff by pressing CTRL+ALT+DEL keys on your keyboard and select “Signout.”

Passwords: Keep your passwords secured in a locked file cabinet or on your password-locked phone. This reduces the chance of someone unauthorized gaining access to your devices and to our network.

As always, if you SEE something, SAY something. Always contact your IT personnel if there is anything suspicious on your device or in email.

PTSMC Happenings

- OUT IN THE COMMUNITY THIS MONTH -

Sunday, March 1st at 9 am New Haven at Shamrock & Roll Race Saturday, March 7th at 9 am Groton & New London at Kelley’s Pace Hare Hop 5k

Avon took a staff outing to The Yoga Shop in West Hartford.

Wednesday, March 11th at 12 pm Stephanie Weyrauch presenting “Mind Over Bladder” at the JCC of Woodbridge

Meghan Blanusa, PT Naugatuck, presented on arthritis at the Naugatuck YMCA.

Saturday, March 14th at 10 am Naugatuck, New Milford, Southbury, Waterbury & Watertown at Shamrock Shuffle Saturday, March 14th at 11 am Fairfield at Fairfield Health & Fitness Expo

Rebecca Petrosino, Partner & Director of Fairfield, presented about different techniques used in PT at the Fairfield YMCA.

Southington and Plainville attended Healthy Family Funfest. Pictured are Sam McMullen, PT Southington, and Kevin Connellan, Partner & Director Plainville.

Thursday, March 26th at 2:30 pm Rob Bass presenting “Vertigo: It’s Enough to Make Your Head Spin” at Middletown Senior Center

Groton participated in the Groton Senior Center’s Souper Bowl Sunday.

Sunday, March 29th at 10 am Waterbury at NVCC Food Pantry 5k

Bryan Baker, PT Westbrook; Ann Hall, PT Essex; and Kelley Cahill, PTA Essex, presented on fall prevention at Joint Effort.

SoCIAl Media Sensation Erin Walsh, Partner & Director Waterbury

Erin filmed a video with Crunch Fitness in which she demonstrated some stretches that gymgoers should do in order to keep working out. Check it out at www.ptsmc.com/videos.

I

Emily Searle, PT Branford, presented “Mind Over Bladder” at the Soundview Family YMCA.

My PT

Thanks to everyone who sent in videos for our special Valentine’s Day Video! The final video is a compilation of patients expressing why they love their PTSMC clinician. Be sure to watch the video on our Facebook page. Pictured is Mary Clark, PT New Haven, with a patient.

Life Beat 4 Day Detox Soup Ingredients: ½ medium cabbage, chopped 3 cans organic chopped tomatoes (44 oz) 1 small can organic tomato paste 1 ½ cups dry, uncooked lentils 2 can organic black or kidney beans 12-14 organic baby carrots, or 4 large, sliced 2 stalks organic celery, sliced 1 large organic red pepper, chopped 12 oz organic mushrooms, sliced 3 handfuls organic spinach 1 organic sweet onion, chopped 4-5 cloves organic garlic, pressed A few springs organic basil Fresh cracked pepper to taste BRAGGS Organic Sprinkles 24 Herbs and Seasoning A few dashes of hot sauce to taste ½ gallon spring water Instructions: 1. Combine all ingredients in a large stock pot.

2. Bring to boil and allow to cook on high, uncovered, for 15 – 20 min.

3. Turn down to simmer and allow to cook, covered, for 1 ½ - 2 hours.

This soup yields enough to be eaten for all meals over the course of 4 days.

#GETMOVING CHALLENGE Spring 2020 #GetMoving challenge is coming soon!

May 1 – May 21 The #GetMoving Challenge is a fun, competitive, and healthy program for all employees! It is a commitment to 3 weeks of being active, practicing what we preach, and a chance to win prizes. Save the dates - more details to come in next month’s PULSE.

Wellness webinar!

Be on the lookout for emails about Wellness Webinars that will be offered through Cigna, our employee 2020 Medical benefit provider.

All employees may sign up for the webinars.

Flu Proof Your Home When it comes to your health, you can never be too careful!

Here are some tips to keep you healthy!

Disinfect surfaces such as counter tops, dining tables, bathroom counters Wash your hands often with soap and water, especially any time you arrive home Wash your linens each week Clean your devices: computers, phones, tables, cell phones, tv remotes Avoid touching your eyes, nose, and mouth Cover your nose and mouth with your elbow or a tissue when you sneeze or cough - make sure to throw away tissues immediately!

What Happened in MARCH of 2000?

March 4, 2000- The PlayStation 2 was released in Japan.

The PS2 would become the best selling video game console of all time with over 155 million units sold.

Clinics that Opened in FEBRUARY Westbrook opened in March 2003. They’re pictured on their 15th anniversary in 2018.

March 11, 2000- St. John’s beat UConn 80-70 in the Big East Men’s Tournament Final.

Avon opened in March 2006. They’re pictured from their holiday party in 2019.

March 26, 2000 - American Beauty won 5 awards at the 72nd Academy Awards, including Best Picture. Pictured from left to right are other big winners: Michael Cane (Best Supporting Actor), Angelina Jolie (Best Supporting Actress), Hillary Swank (Best Actress), and Kevin Spacey (Best Actor).

20th Anniversary Spirit Day Friday, March 20th is March Madness day!

Employees and patients are encouraged to wear apparel repping their favorite college team.

Windsor opened in March 2013. They’re pictured on their grand opening in 2013.

Pinks, maroons, whites &

hearts DAY Staff and patients dressed up for our second spirit day on February 20th, pink, maroon, white, and hearts day!

Check out the photos below.

Waterbury

Watertown

Guilford

Waterbury

Groton

Southington

New Milford

New Haven Groton

Fairfield

Plainville

Avon